ABSTRACT
Positional cranial deformities are associated with prematurity evolving during the first 2 years of life due to the malleable characteristics of the skull, the first year being the main/primary therapeutic window for intervention. The objectives were (a) to describe health characteristics, peri- and postnatal pathologies, and positional cranial deformities in infants enrolled in an early intervention program and (b) to analyze the effects of a parent education-based intervention program on positional cranial deformity in premature infants. A quantitative, analytical, longitudinal study was conducted. It included 103 premature infants enrolled in an early intervention program (EIP) during the year 2017, all under 4 months of corrected age, to whom a parent education-based intervention program was applied. Cranial circumference, cranial width, diagonals, and anteroposterior diameter were measured, and the cranial asymmetry index (CAI) and cephalic index (CI) were calculated at baseline and during two subsequent evaluations separated by a 3-month period. The main results showed that 75.7% of the infants belonged to a very premature gestational age category, and 57.3% had an adequate weight for gestational age. The most frequent pathologies were premature jaundice, premature anemia, and hyaline membrane disease. The most frequent positional cranial deformity was plagiocephaly. The parent education-based intervention program resulted in (1) a significant decrease in the CAI and a significant increase in the IC, (2) plagiocephalies: an increase in the mild category and a decrease in the moderate + severe categories, (3) brachycephalies: a decrease in the absence category and an increase in the moderate + severe category, and (4) dolichocephalies: an increase in the absence category and a decrease in the mild category. In conclusion, the recommended first line of intervention was not enough for this population, and future studies should support the development of national clinical guidelines, where education is complemented with other therapeutic measures.
ABSTRACT
Prematurity is a risk factor for positional cranial deformities since preterm infants have a more malleable skull and are susceptible to deformities due to external pressures. OBJECTIVES: To describe positional cranial deformities and peri/postnatal pathologies in preterm infants and to analyze the association between gestational age, birth weight, length of hospitalization, and severity of cranial deformities measured by the Cranial Vault Asymmetry Index (CVAI) and the Cephalic Index (CI). PATIENTS AND METHOD: Analytic, cross-sectional study. 103 preterm infants aged under 4 months of corrected age admitted during 2017 to an Early Intervention Program (EIP) were included. Participants were classified according to gestational age as follows: extremely preterm (< 28 weeks), very preterm (28-32 weeks), and moderate-to-late preterm (32-37 weeks). Head circumference, anteroposterior diameter, width, and head diagonals were measured, and the CVAI and CI were calculated. Peri- and postnatal history was obtained from clinical records. RESULTS: 103 preterm infants were evaluated (17 extremely preterm, 78 very preterm, and 8 moderate-to-late preterm). 99 (96.1%) of the preterm infants had positional cranial deformity and, regardless of the degree of prematurity, presented similar cranial anthropometric measurements. Mild plagiocephaly was the most frequent cranial deformity in all groups. We observed a positive association between the days of hospitalization and the CVAI and there was no relationship between the degree of prematurity and the severity of the positional cranial deformation. CONCLUSIONS: Most of the patients admitted to the EIP presented positional cranial deformities, mainly mild plagiocephaly, regardless of the degree of prematurity. The presence of plagiocephaly was positively associated with prolonged periods of hospitalization. No relationship was confirmed between the degree of prematurity and the severity of the positional cranial deformity.
Subject(s)
Infant, Premature , Plagiocephaly , Infant, Newborn , Infant , Humans , Cross-Sectional Studies , Gestational Age , Birth Weight , Plagiocephaly/epidemiologyABSTRACT
El cáncer de pulmón es una de las causas de muerte por cáncer más frecuentes a nivel mundial. Específicamente el cáncer por células no pequeñas (CPCNP) es la neoplasia pulmonar más común y conforma cerca del 87% de todos los tumores pulmonares a nivel mundial. El tratamiento Gold Standard de esta enfermedad es la resección pulmonar, la cual genera como consecuencia deterioro en la capacidad para realizar ejercicio, en la calidad de vida y presencia de disnea. Estudios sugieren que programas de entrenamiento post-resección pulmonar provocarían efectos positivos sobre esta población, sin embargo, los resultados publicados son controversiales. A continuación, se presentará el caso de una mujer sometida a lobectomía pulmonar secundario a CPCNP ingresada a un programa de entrenamiento, cuyo objetivo es evaluar los efectos de éste sobre la capacidad para realizar ejercicio, calidad de vida y la sensación de disnea.
Lung cancer is one of the most frequent causes of death worldwide. Non-small-cell lung cancer (NSCLC) is the most common lung neoplasm, accounting for 87% of lung cancers. The gold standard treatment is lung resection which causes deterioration in the capacity for exercise, reduced quality of life and dyspnea. Studies indicate that training programs after lung resection can have positive effects on this population; however the published results are controversial. Wepresent the case of a woman given a lung lobectomy for NSCLC who was admitted to a training program.Weevaluate its effect on her capacity for exercise, quality of life and sensation of dyspnea.
